3 Year old Kindergarten - Application Form 2024

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Instructions

Please ensure that you:

place a number (1 to 12) against ALL kindergarten preferences on page 4 of this application and
each preference number is only entered once

You can save and continue this application by clicking "Save and Complete Later" button found at the bottom of this form.

Supporting documentation you will need (where applicable) includes:

Child's birth certificate OR Statutory Declaration in the event that you do not have a birth certificate OR Passport.
Proof of Warrnambool residency in the form of
A Utility Bill ie. Electricty, Gas, telephone bill issued in the last 3 months, or
Copy of a relevant building permit, or
Copy of a tenancy agreement
Child's current immunisation statement from Medicare
Concession Card if applicable.
Letter from appropriate professional or support agency verifying your child is assessed as having additional needs, a disability or developmental delay if applicable.
Medical documentation displaying a professional diagnosis for your child if applicable.
Letter from a case manager or support agency verifying how your child meets high priority criteria if applicable.

If you have any issues or need assistance with your application our Early Years Administrators will be only too happy to assist.

Please contact us on 55594800 or send an email along with your contact details with a brief explanation of your issue to childandfamily@warrnambool.vic.gov.au

Parent/Guardian Information

A Guardian includes parent of the child and/or a person with parental responsibilities for the child under a decision or court order. Parental responsibility is a term defined under section 61C of the Family Law Act 1975, which means all the duties, powers, responsibilities and authority which, by law, parents have in relation to children.

Parent/ Guardian 1

First Name *

Middle Name

Last name *

Known as (preferred name)

Date of Birth *

Relationship to child *

Relationship - Other

Is this the Primary Guardian *

YesNo

Email Address *

Mobile Number *

Home Number

Work Number

Address *

Street *

City *

State *

Postcode *

This Guardian is authorised to

Authorise the service to seek medical treatment from a registered medical practitioner hospital or ambulance service, including transportation of the child(ren) by an ambulance serviceAuthorise the service to administer medication to the child(ren)Authorise the service to take the child(ren) outside the service on excursions or outings, with the service's educatorsBe contacted in an emergency concerning the child(ren)Drop off/pick up the child(ren) to/from the serviceAccess information of the child(ren) via Xap Guardian app

Parent/Guardian 2 (If Applicable)

First Name

Middle Name

Last name

Known as (preferred name)

Date of Birth

Relationship to child

Relationship - Other

Is this the Primary Guardian

YesNo

Email Address

Mobile Number

Home Number

Work Number

Address

Street

City

State

Postcode

This Guardian is authorised to

Nominee

In case of emergency, service staff will contact guardians initially. If contact is unsuccessful, the nominee will be contacted as per the authorisations and the contact priority set for them. An authorised nominee is defined under section 170 of national laws as a person who is authorised by guardians to collect the child from service.

We MUST have at least 1 nominee who is fully authorised

First Name *

Middle Name

Last name *

Known as (preferred name)

Relationship to child *

Relationship - Other

Email Address *

Mobile Number *

Home Number

Work Number

Address *

Street *

City *

State *

Postcode *

This Nominee is authorised to

3 Year old Kindergarten - Application Form 2024

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Child Information

First Name *

Middle Name

Last Name *

Known as (preferred name)

Date of Birth *

Gender *

Resides with *

Please provide more details (if applicable)

Address *

Street address *

City *

State *

Postcode *

Please upload a copy of the childs birth certificate *

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Please upload an Immunisation statement from Medicare OR Medical Exemption from registered medical practicioner *

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Additional Needs and requirements

Does the child have a diagnosed disability? *

YesNo

Please specify the diagnosed disability

Please upload supporting Documents (if applicable)

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Is the child accessing any specialist services or on a waiting list for such services? *

YesNo

Specialist Services description and details

Please upload supporting Documents (if applicable)

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Does the child have any other additional needs *

YesNo

Please describe the other additional needs

Please upload supporting documents (if applicable)

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Does the parent/guardian have any specific conditions that make it difficult to get the child to child care? (e.g. a disability or medical condition) *

YesNo

Please describe the specific condition

Please upload supporting documents (if applicable)

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3 Year old Kindergarten - Application Form 2024

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Priority of Access

Please indicate if your child / family meet any of the following criteria and upload the relevant documentation as requested.

Do you currently reside in the Warrnambool City Council Municipality?

Please upload a copy of the following documents as applicable

A utility bill ie. Electricity, Gas, Telephone bill issued in the last 3 months, or
Copy of a relevant building permit, or
Copy of a Tenancy agreement

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Has this child previously attended one of the following programs at the preferred kindergarten (your first preference)?
Early Start funded placement,
WCC Early Learning Centre/s Care and Education,
WCC 3 Year Old Kindergarten
WCC 4 Year Old Kindergarten

Children in Aboriginal and Torres Strait Islander families.

Children in families which include a disabled person.

Children in families from a non-English speaking background.

Children in socially isolated families.

Child/Parent/Guardian with a Commonwealth Health Care Card.

Please upload a copy of the Commonwealth Heath Care Card *

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Child/Parent/Guardian with a Commonwealth Pensioner Concession card.

Please upload a copy of the Commonwealth Pensioner Concession card *

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Child in a family with triplets and/or quadruplets attending preschool in the same year.

Child/Parent/Guardian with a Dept. of Veterans Affairs Gold or White Card.

Please upload a copy of the Veterans Affairs concession card *

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Child/Parent/guardian is on Asylum Seeking bridging Visas A – F.

Please upload a copy of the Asylum Seeking Bridging Visa *

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Child/Parent/Guardian is on Temporary Protection/Humanitarian Visas 447, 451, 785, 786,866

Please upload a copy of the Temporary Protection/Humanitarian Visa *

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Child/Parent/Guardian is on Refugee and Special Humanitarian visas 200-217. Emergency Rescue Visa 203. Woman at Risk Visa 204

Please upload a copy of the Refugee Special Humanitarian Visa *

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Child/Parent/Guardian is on Resolution of Status (RoS) visas, Class CD, Subclass 851.

Please upload a copy of the Resolution of Status Visa *

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Application is referred from a third party agency.

Agency Name *

Support Worker Name *

Child with additional needs.

Please upload a copy of letter from professional, NDIS plan or other supporting documents *

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A child currently in out of home care.

POA Score

3 Year old Kindergarten - Application Form 2024

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Kindergarten Preferences

Number your preferences from 1 to 12 for Kindergarten groups.

Start with 1 for your most preferred group and number all groups through to 12 as your least preferred group.

Very Important:

A preference number must be entered against every service and
this number cannot be entered more than once.

This form will not submit if you have entered duplicates or insufficient selections and will delay the processing of your application.

Sessional Kindergarten

Early Learning Centre Kindergartens

These services are located in a Early Learning Centre. The session is a combination of kindergarten and child care. The kindergarten program is taught by a qualified kindergarten teacher. Each child will be allocated to 15 hours of kinder per week (3 x 5 hours). Child Care operates outside of the kindergarten hours and during school holidays. All families are charged for child care during the school holidays. Fees are charged at a daily rate and families using these services may be eligible for Child Care Subsidy.
Please note these services start earlier than the other kindergarten programs operating a child care program during January.

Preference Calculation

Your preferences selected either contain duplicates or insufficient selections, please note

A preference number must be entered against every service and
this number cannot be entered more than once.

Disclaimer: The groups on offer are based on current enrolment numbers and anticipated teacher/student ratios for 2023. Variance in these factors may impact on the final number of groups offered. Applicants will be informed of any changes at the time of the first round offers. Council uses a “Priority of Access” criterion to identify which children are allocated places if more applications are received for a kinder group than there are places available.

This application has been submitted by the following Parent / Guardian

As the person with lawful authority for the child or children referred to on this enrolment form:

I have read and understood the kinder information kit, policies and Fees etc.
*

I Have read the Privacy Statement
*

Parent/ Guardian Name *

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